• The National Audit Office has published its report on the financial sustainability of the NHS.
• It argues that substantial deficits in some parts of the system, offset by surpluses elsewhere coupled with growing waiting lists and year-on-year increases in waiting times, is not sustainable. 
• It highlights a number of risks the delivery of the NHS long term plan including key areas of health spending such as education, public health and capital investment, as well as the need for a long term solution to a growing social care crisis.
• It warns that extra funding will not be used effectively due to staff shortages.

Responding to the NHS financial sustainability report by the National Audit Office (NAO), the chief executive of NHS Providers, Chris Hopson said:

“We welcome this accurate reflection of the current financial state of the NHS. The provider sector faces a number of challenges to deliver the ambitions of the long term plan and return to financial balance.

“This is the culmination of four years of rising demand, the biggest financial squeeze in NHS history and growing workforce shortages.

“NHS trusts welcomed the long term plan which sets out an ambitious vision to putting health and care back on a sustainable footing. However independent commentators are clear that the average 3.4% yearly increase is not enough to meet every aspiration. We will need to ruthlessly prioritise while not underestimating the scale of the task to return the sector to a surplus.

We will need to ruthlessly prioritise while not underestimating the scale of the task to return the sector to a surplus.

Chris Hopson    

“Last week the planning guidance for 2019/20 set out the first steps of how this extra investment will help trusts begin to return to financial balance, recover performance and address workforce shortages. Trusts welcomed the overall new financial regime which will ensure that trusts are supported towards a realistic and deliverable path to financial recovery.

“The NAO is right to say that workforce shortages remain a significant risk to the NHS and its ability to deliver on this investment effectively. The long term plan cannot be delivered while there are still over 100,000 staff vacancies across the NHS. We need urgent action on this and it is a major concern that we will have to wait until later in the year for a comprehensive workforce plan.

The long term plan cannot be delivered while there are still over 100,000 staff vacancies across the NHS.

Chris Hopson    

“We will be paying close attention to the upcoming spending review which will need to address vital areas not covered by the funding settlement but critical to achieving financial balance. These include investment in NHS buildings and equipment, public health and NHS training budgets.

“A long-term solution to social care is also a missing piece of the puzzle. Without addressing the crisis in social care, we risk devaluing every pound invested in the NHS. We look forward to the green paper due in the coming weeks.”